Palliative Care: A Medical Specialty Advocating for Patients and Families

The overwhelming diagnosis of a serious disease; significant debilitating symptoms; a terminal illness; there are many reasons patients or family members might need the help of palliative medicine. Since it is a relatively new medical specialty, many people do not know what it is or how it can help.

“Palliative care and hospice are different,” explained Todd M. Sauer MD, medical director of the palliative care service at The Nebraska Medical Center. “Hospice is restricted to people who have a prognosis of less than six months to live. However, palliative care does not have that restriction because it does more than just help people at the end of their life.”

The palliative care program began at The Nebraska Medical Center in 2009. Its mission is to provide intensive symptom management and improve the quality of life for patients and their families.

Dr. Todd M. Sauer consults with another member of The Nebraska Medical Center’s medical staff

Dr. Sauer, as the program medical director partners with nurse practitioners Carri Siedlik APRN, and Angie Andersen APRN, to make up the palliative care department. Together, they help patients’ families understand their medical situation and the options that are available.

“We are advocates for a patient and family. We’re not there to make decisions for them, but help show them what choices and options they have ahead of them,” said Dr. Sauer. “We discuss their goals, needs, and wishes so that we can help them and their medical team make the right choices for their care.”

“Medicine is curative,” said Siedlik. “We get so focused on fixing things; we don’t want to lose focus on the patient.”

April 16 is National Healthcare Decisions Day, an initiative aimed at getting more people to learn about advance directives and to share their wishes about what kind of healthcare they would like to receive in the event they are not able to communicate.

Dr. Sauer commonly encounters situations where families are not sure what their loved one would want.

“Our medical system puts a lot of pressure on patients and families to make heavy medical decisions,” he said. “Palliative care can try to help explore with the family what the situation is and what the choices are so they can make the most appropriate decision for them and their loved one.”

“I often hear the question, ‘Is this the right thing to do?’ There is no right or wrong answer,” said Siedlik. “Every person is different. Some people will go through a lot of pain and suffering until the very last moment of their lives; others choose to focus more on their comfort earlier in their disease. Most of us are somewhere in between. But the most important thing is to find out what kind of person they are and what they are willing to go through.”

In its first year at the medical center, the palliative care department exceeded many expectations. The palliative care service expected to consult on about 100 cases. They were called 240 times. The team expects to consult with more than 500 patients this year. Dr. Sauer believes that is proof of the need for palliative care, and of its acceptance at the medical center.

“Our service helps support the nurses who are providing the intense hour-to-hour care to our patients,” said Dr. Sauer. “We work closely with the staff to provide holistic care for our patients’ – body, mind, and spirit.”